Active NPI
Anderson Lee Russell, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Powder Springs, GA
National Provider Identifier
1366073124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- RPH018427
- Practice address
- 4150 Macland Rd
Powder Springs, GA 30127-1202 - Phone
- (770) 222-5190
- NPI assigned
- Jan 30, 2020
- Last updated
- Jun 1, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH018427 | GA | Primary |
Addresses
Primary practice location
4150 Macland Rd
Powder Springs, GA 30127-1202
Mailing address
4150 Macland Rd
Powder Springs, GA 30127-1202
Phone (770) 222-5190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH018427 | GA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co | Past | Accepting new patients | |
| The Kroger Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1366073124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 MACLAND RD",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301271202",
"telephone_number": "770-222-5190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 MACLAND RD",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301271202",
"telephone_number": "770-222-5190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "ANDERSON",
"middle_name": "LEE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-30",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "GA",
"license": "RPH018427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.